Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives

Michele Carron, Francesco Bertoncello, Giovanna Ieppariello Department of Medicine, Anesthesiology, and Intensive Care, University of Padova, Padua, Italy Abstract: The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future d...

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Autores principales:	Carron M, Bertoncello F, Ieppariello G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Sugammadex Aging Elderly Neuromuscular blockade. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/e79c29ea5a124dee8a3d1b958459744b
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spelling	oai:doaj.org-article:e79c29ea5a124dee8a3d1b958459744b2021-12-02T02:13:56ZProfile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives1178-1998https://doaj.org/article/e79c29ea5a124dee8a3d1b958459744b2017-12-01T00:00:00Zhttps://www.dovepress.com/profile-of-sugammadex-for-reversal-of-neuromuscular-blockade-in-the-el-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Michele Carron, Francesco Bertoncello, Giovanna Ieppariello Department of Medicine, Anesthesiology, and Intensive Care, University of Padova, Padua, Italy Abstract: The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients. Therefore, neuromuscular blockade in the elderly should be carefully monitored and completely reversed before awakening patients at the end of anesthesia. Acetylcholinesterase inhibitors are traditionally used for reversal of neuromuscular blockade. Although the risk of residual neuromuscular blockade is reduced by reversal with neostigmine, it continues to complicate the postoperative course. Sugammadex represents an innovative approach to reversal of neuromuscular blockade induced by aminosteroid neuromuscular-blocking agents, particularly rocuronium, with useful applications in clinical practice. However, aging is associated with certain changes in the pharmacokinetics of sugammadex, and to date there has been no thorough evaluation of the use of sugammadex in elderly patients. The aim of this review was to perform an analysis of the use of sugammadex in older adults based on the current literature. Major issues surrounding the physiologic and pharmacologic effects of aging in elderly patients and how these may impact the routine use of sugammadex in elderly patients are discussed. Keywords: sugammadex, aging, elderly, neuromuscular blockade, rocuronium, anesthesia, safetyCarron MBertoncello FIeppariello GDove Medical PressarticleSugammadexAgingElderlyNeuromuscular blockade.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 13-24 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sugammadex Aging Elderly Neuromuscular blockade. Geriatrics RC952-954.6
spellingShingle	Sugammadex Aging Elderly Neuromuscular blockade. Geriatrics RC952-954.6 Carron M Bertoncello F Ieppariello G Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives
description	Michele Carron, Francesco Bertoncello, Giovanna Ieppariello Department of Medicine, Anesthesiology, and Intensive Care, University of Padova, Padua, Italy Abstract: The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients. Therefore, neuromuscular blockade in the elderly should be carefully monitored and completely reversed before awakening patients at the end of anesthesia. Acetylcholinesterase inhibitors are traditionally used for reversal of neuromuscular blockade. Although the risk of residual neuromuscular blockade is reduced by reversal with neostigmine, it continues to complicate the postoperative course. Sugammadex represents an innovative approach to reversal of neuromuscular blockade induced by aminosteroid neuromuscular-blocking agents, particularly rocuronium, with useful applications in clinical practice. However, aging is associated with certain changes in the pharmacokinetics of sugammadex, and to date there has been no thorough evaluation of the use of sugammadex in elderly patients. The aim of this review was to perform an analysis of the use of sugammadex in older adults based on the current literature. Major issues surrounding the physiologic and pharmacologic effects of aging in elderly patients and how these may impact the routine use of sugammadex in elderly patients are discussed. Keywords: sugammadex, aging, elderly, neuromuscular blockade, rocuronium, anesthesia, safety
format	article
author	Carron M Bertoncello F Ieppariello G
author_facet	Carron M Bertoncello F Ieppariello G
author_sort	Carron M
title	Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives
title_short	Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives
title_full	Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives
title_fullStr	Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives
title_full_unstemmed	Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives
title_sort	profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/e79c29ea5a124dee8a3d1b958459744b
work_keys_str_mv	AT carronm profileofsugammadexforreversalofneuromuscularblockadeintheelderlycurrentperspectives AT bertoncellof profileofsugammadexforreversalofneuromuscularblockadeintheelderlycurrentperspectives AT ieppariellog profileofsugammadexforreversalofneuromuscularblockadeintheelderlycurrentperspectives
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Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives

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